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Chronic Lymphocytic Leukemia Research · Journal article
European Heart Journal Supplements · August 1, 2026
A consensus or society position rather than new primary data.
This retrospective single-centre audit of 216 patients with multiple myeloma or Waldenström's macroglobulinaemia found substantial gaps in pre-treatment cardiovascular risk assessment prior to proteasome inhibitor therapy, despite ESC guidance. Half of patients had high baseline cardiovascular risk, yet two-thirds lacked baseline troponins, 61% lacked BNP/NT-proBNP, 56% had no pre-treatment ECG, and 72% had no baseline echocardiography. The findings highlight a compliance problem rather than evaluating an intervention.
Retrospective single-centre audit. Patients at an academic tertiary referral hospital diagnosed with multiple myeloma or Waldenström's macroglobulinaemia treated with proteasome inhibitors.. Intervention: Proteasome inhibitor-based treatment (bortezomib or carfilzomib).. n = 216. Single tertiary referral centre (location not specified in abstract)..
216 patients treated with proteasome inhibitors: 88.9% with multiple myeloma, 11.1% with Waldenström's macroglobulinaemia 50% of patients had high baseline cardiovascular risk, 33.3% moderate, 16.7% low (by HFA-ICOS risk score) 66.7% of patients did not have baseline troponins measured prior to treatment
No follow-up data on cardiovascular outcomes or on-treatment monitoring; does not establish clinical impact of assessment gaps on patient safety or outcomes.
Clinicians and haematologists should recognize substantial gaps in pre-treatment cardiovascular assessment at this centre despite published ESC guidance, suggesting need for systematic implementation of baseline risk stratification protocols before initiating proteasome inhibitor therapy, particularly in patients at high cardiovascular risk.
Single-centre retrospective audit of compliance with published ESC surveillance guidance; identifies practice gaps rather than testing an intervention, with no comparator group or efficacy endpoint.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians and haematologists should recognize substantial gaps in pre-treatment cardiovascular assessment at this centre despite published ESC guidance, suggesting need for systematic implementation of baseline risk stratification protocols before initiating proteasome inhibitor therapy, particularly in patients at high cardiovascular risk.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Abstract Introduction Thanks to encouraging trial results, proteasome inhibitors have become mainstays of therapy in patients with newly diagnosed and relapsed multiple myeloma. Similar beneficial findings have been identified with their use in waldenström’s macroglobulinaemia. Patients treated with proteasome inhibitors have a high incidence of coexistent comorbidities leading to an increased baseline cardiovascular risk, and newly developed heart failure is a frequently developed adverse effect on treatment. The European Society of Cardiology have published surveillance guidance for patients receiving proteasome inhibitors, including baseline cardiovascular risk assessment and on-treatment monitoring. Purpose We performed a single centre study to assess the quality of pre-treatment risk assessment in patients with haematological malignancies receiving proteasome inhibitor-based treatments. Methods Information was collected from an academic tertiary referral hospital. Data was retrospectively extracted on patients diagnosed with multiple myeloma or waldenström’s macroglobulinaemia who were treated with proteasome inhibitors using pharmacy dispensing records. Electronic and handwritten records were reviewed for each patient to identify for the presence of comorbidities, cardiovascular biomarker levels, ECG findings, echocardiography reports, and details on referrals to the on-site cardiology service prior to commencing treatment. Baseline cardiovascular risk was calculated for each patient using the Heart Failure Association-International Cardio-Oncology Society risk score. Results Over the study period, 216 patients with multiple myeloma or waldenström’s macroglobulinaemia were treated with proteasome inhibitors. 50% of patients were male, 50% were female. 88.9% of patients had multiple myeloma; 11.1% had waldenström’s macroglobulinaemia. 83.3% of patients received bortezomib; 16.7% received carfilzomib. 50%, 33.3% and 16.7% of patients had high, moderate and low baseline cardiovascular risk scores respectively. 66.7% and 61.1% of patients did not have baseline troponins and BNP/NT-pro-BNPs taken respectively. 55.5% and 72.2% of patients did not undergo pre-treatment ECGs or transthoracic echocardiographs respectively. Conclusions Patients with multiple myeloma treated with proteasome inhibitors are frequently not receiving a full baseline cardiovascular risk assessment prior to commencing treatment. Future efforts will need to focus on improved compliance rates to ensure appropriate risk stratification, and appropriate cardiovascular monitoring, while on treatment.
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